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Chameter and valne of ore _ _ _ _ v _~!-~[~_ _ _ _ _ _ _ _ , _ _ _ / _ _~-_~_ ~ _ ~. <br />-----------------------------------------------------------=--------------------------- <br />~ R ~ '' <br />I <br />,L~ I ~ i <br />I. <br />;';~ <br />y <br />i <br />l ~i <br />~~ <br />~~ <br />'I <br />i !I <br />;'~ Nnme of mill (if nny), cbnmeter and cupncity _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ <br />---------------------- <br />--------------------------------------------------------------- <br />Chnrneter of eurfaco improvomenta ~C.~t> - _ _!~-~-!-Y..!%(-.C2~,i~Q~,_ ~.~.~ <br />- - ------ <br />- -- - -- - ---~---~---3-~--------- ------ ~~-~-~_<-; - ----- <br />-------- <br />/~ - - ~~- ~ _- ~~ YQ-,~. ~- ~....~ _ ~~!~`'z<= ~ ~F`L`_ gam- ~-~`~ <br />-----ti-- -,- - O <br />Amount and cLnracter of ender-ground evelopment_ _ _ _ _ _ _ _ _ <br />--------------------------- <br />--- <br />----- <br />- , <br />1 <br />_________________________________________________________ <br />__________________________________________________________ <br />___________________________________________________________ <br />~" <br />Signed_______.____ <br /> <br />